Depressed patients with dysfunctional families: description and course of illness.

Sixty-eight depressed patients were subdivided according to their family's level of family functioning into functional and dysfunctional groups. Patients from dysfunctional families did not differ from those from functional families on measures of severity of depression, chronicity of depression, depression subtypes, other nonaffective psychiatric diagnoses, history of depression, or neuroendocrine functioning. Patients from dysfunctional families did have significantly higher levels of neuroticism. A 12-month follow-up of these patients indicated that depressed patients with dysfunctional families had a significantly poorer course of illness, as manifested by higher levels of depression, lower levels of overall adjustment, and a lower proportion of recovered patients. Thus, impaired family functioning appears to be an important prognostic factor in major depression.     

Comparing the Characteristics of Homeless Adults in Poland and the United States

This study compared the characteristics of probability samples of homeless adults in Poland (N = 200 from two cities) and the United States (N = 219 from one city), using measures with established reliability and validity in homeless populations. The same measures were used across nations and a systemic translation procedure assured comparability of measurement. The two samples were similar on some measures: In both nations, most homeless adults were male, many reported having dependent children and experiencing out-of-home placements when they themselves were children, and high levels of physical health problems were observed. Significant national differences were also found: Those in Poland were older, had been homeless for longer, showed lower rates on all psychiatric diagnoses assessed (including severe mental and substance abuse disorders), reported less contact with family and supportive network members, were less satisfied when they sought support from their networks, and reported fewer recent stressful life events and fewer risky sexual behaviors. Culturally-informed interpretations of these findings and their implications are presented.     

A randomized clinical trial of group and individual Cognitive-Behavioral Therapy approaches for Social Anxiety Disorder

To compare the effectiveness of two Cognitive-Behavioral Therapy (CBT) interventions—an individual and a group intervention—in Social Anxiety Disorder therapy. We compared the two treatment groups against a waitlist condition in a randomized clinical trial with 86 young adults. The individual CBT intervention was Trial-Based Cognitive Therapy (TBCT) developed by De-Oliveira, a novel technique in which the therapist engages the patient in a simulated judicial trial with the goal of identifying and changing core dysfunctional beliefs. The group intervention consisted of exposition therapy based on the Hofmann and Otto protocol (Group CBT) to restructure negative and dysfunctional cognitions regarding social situations. Both interventions reduced psychiatric symptoms from pre- to post-test and primary social anxiety and depression symptoms relative to waitlist controls. The interventions were recently introduced in Brazil, and this is the first randomized control trial to compare TBCT and this Group CBT, which were effective in assessing changes in social anxiety symptoms as well as co-occurring psychiatric symptoms.     

Proneness to hallucinations and delusions in a non‐clinical sample: Exploring associations with metacognition and negative affect

Commonly, individuals prone to hallucinations and delusions hold dysfunctional metacognitive beliefs and report higher levels of negative affect, yet, these associations have not been clearly investigated in non‐clinical samples due to the failure to control for high intercorrelations between variables. The aim of the current study was to investigate how hallucination and delusion proneness are associated with dysfunctional metacognitions and negative affect. A cross‐sectional sample of 715 students free from psychiatric diagnoses (M_age = 28.1 years, SD = 10.9, range 18–65) completed the Launay‐Slade Hallucination Scale (LSHS‐R); Peters et al. Delusion Inventory (PDI‐21); Depression, Anxiety, and Stress Scale (DASS‐21); and the Metacognition Questionnaire (MCQ‐30). Findings that participants who were prone to both hallucinations and delusions reported elevated levels of negative affect support the need for targeted mental health treatment for individuals who experience psychological distress related to their hallucinatory and delusional experiences. While metacognition beliefs of need to control thoughts and cognitive self‐consciousness, along with the anxiety and stress DASS‐21 subscales appeared as significant cross‐sectional predictors of proneness to hallucinations and delusions, only metacognitions demonstrated any notable predictive value for delusion proneness. This finding questions the role of metacognitions in determining hallucination and delusion proneness in non‐clinical samples.     

Suicidal adolescents' perceptions of their family environment.

This study examined the extent to which adolescents' perceptions of their family environments were associated with suicidal behavior. Fifteen suicidal adolescents, 14 psychiatric controls, and 14 normal controls rated their families on cohesiveness, adaptability, parent-adolescent communication, parental caring, and parental over-protectiveness. Suicidal adolescents rated their families as the least cohesive and most rigid of the 3 groups, suggesting that adolescent suicidal behavior may occur when isolation is experienced within an inflexible family system. Suicidal and psychiatric control adolescents rated their families as similarly dysfunctional along the remaining variables, and as more dysfunctional than families of normal control adolescents. The implications of these findings are discussed, and it is suggested that several characteristics commonly attributed to families of suicidal adolescents may actually be general risk factors for adolescent psychopathology, rather than for suicidal behavior specifically.     

Problem gambling,gaming and Internet use in adolescents: Relationships with emotional intelligence in clinical and special needs samples

The study examined the relationship between emotional intelligence (EI) and several addiction-related behaviours (gambling problems, Internet abuse, and computer gaming misuse) in two adolescent samples: 270 clinical outpatients (180 males and 90 females) and 256 special needs students (160 males and 96 females). Gambling problems, Internet abuse, and computer gaming misuse were positively inter-correlated in both samples; approximately half of the variability in these addiction-related behaviours could be accounted for by a common dysfunctional preoccupation latent variable. Latent variable path analysis found emotional intelligence to be a moderate predictor of dysfunctional preoccupation in both adolescent samples.     

Down on the upside: redemption,contamination, and agency in the lives of adult children of alcoholics

We investigated differences in the nature and implications of Adult Children of Alcoholics (ACOAs; n?=?53) and non-ACOAs’ (n?=?80) narrative identities. Participants described six autobiographical narratives and completed measures of emotional functioning. Narratives were coded for redemptive (bad things turning good), contaminated (good things turning bad), and agentic (perceived control) imagery. ACOAs exhibited similar levels of redemptive and contaminated imagery, and lower levels of agency in their narratives, relative to non-ACOAs. In addition, themes of redemption, contamination, and agency corresponded divergently with emotional functioning. Among ACOAs, narrative redemption and agency were related to poorer emotional functioning whereas, among non-ACOAs, narrative contamination predicted poorer emotional functioning. These findings provide indication of the manner in which ACOAs story their lives. They also align with the emerging area of research noting that, among certain vulnerable populations, redemptive and agentic imagery serve as predictors of maladaptive functioning.     

Concurrent Validity Studies of the Facial Discrimination Task

We examined the concurrent validity properties of the Facial Discrimination Task (FDT), an instrument for the assessment of facial emotion recognition by comparing it with the widely used Pictures of Facial Affect (PFA). In Study 1, 100 adults with heterogeneous psychiatric diagnoses were administered items of the FDT Emotion Task, the FDT Age Task, and PFA. In Study 2, 25 normally developing preschool children were instructed to label happy, sad, or neutral facial expressions from the FDT and the PFA. Despite methodological differences between the two studies, very similar and high correlations were found between the FDT and the PFA overall correct scores (r = .79 and r = .77, respectively). The data suggest that the FDT and the PFA measure similar competencies in preschoolers and in adults with psychiatric disorders. This finding is important because it establishes the concurrent validity of the FDT in child and adult populations.     

Convergence of Sibling Risk Among Children of Parents with Serious Mental Disorders

We examined child psychiatric diagnoses, behavioral problems, overall symptom impairment, global psychological functioning, intellectual ability, and adaptive behavior in 83 sibling pairs whose mothers were diagnosed with a serious mental disorder. Sibling pairs were assessed for the extent to which they converged on the presence or absence of risk on each adverse outcome and then examined under conditions of high vs. low/moderate family stress. Consistent with the study hypotheses, we found that on each outcome assessed there was evidence for sibling convergence of risk. In addition, family stress was found to significantly moderate sibling risk convergence. The results are discussed in terms of their implications for understanding sibling convergence of risk in these families and for clinical and preventive intervention.     

Relationships among parental reports of child, parent, and family functioning.

Most children with psychosocial problems do not present for treatment in mental health settings. They are managed by primary care physicians. Children with psychosocial problems often have parents and/or families with psychosocial distress. The present study measured associations between parental reports of child, parent, and family functioning in individuals in the general population. Participants were 226 parents of children, aged 2-16 years, who presented for routine primary care. Parents reported on the psychosocial functioning of themselves, their child, and their family. All correlations of measures were significant, ranging from .55 to .23. Similar to data from psychiatric samples, the psychological functioning of children, parents, and families were significantly correlated. Unlike in psychiatric settings, child mental health problems were not as closely related to parent or family distress as parent and family distress were related to each other and to child behavior problems.     

Negative Interpretations of Interpersonal Situations and the Relation Between Low Perceived Support and Psychological Distress Among Divorced Adults1

This research tested hypotheses for a mechanism by which low perceived support may lead to psychological distress. According to social‐cognitive models, perceived support guides the interpretation of interpersonal situations. People with low perceived support interpret these situations more negatively than do people with high perceived support, and these negative interpretations lead to psychological distress. This mechanism is hypothesized to be distinct from similar mechanisms involving other social‐cognitive constructs, such as dysfunctional attitudes. These hypotheses were tested in 2 samples of adults adjusting to divorce. The data were consistent with predictions. Implications for understanding low perceived support's relation to distress and adults' adjustment to divorce were discussed.     

Relationship Between Miscarriage and Dysfunctional Cognitions About Trauma,Coping Mechanisms,and Posttraumatic Growth

Many studies have described grief and psychiatric symptomatology as a typical feature following miscarriage. How women who had a miscarriage (MG) respond to trauma in terms of negative cognitions about their selves and the world, the coping strategies they employ to overcome the effects of the trauma, and what factors might be indicative of posttraumatic growth (PTG) in this population have not been extensively studied so far. We aimed to identify whether women who had a miscarriage (N = 74 vs. N = 82 control subjects) exhibited higher levels of psychological distress symptoms, dysfunctional cognitions, and maladaptive coping strategies, and whether women with lower PTG employed more maladaptive coping strategies, and reported higher levels of dysfunctional cognitions. Group comparisons according to the diagnostic groups based on self-report measures for depression, anxiety, posttraumatic stress disorder and according to the level of PTG, and stepwise linear regression analyses with PTG as the outcome were performed. Our study demonstrated that the MG does not necessarily differ from the control group on some measures of psychopathology, coping mechanisms, dysfunctional cognitions, or PTG. Yet, the MG who exhibited higher levels of PTG had specific predictors, and women with a psychiatric diagnosis differed from participants with no diagnoses on some measures of dysfunctional cognitions, coping mechanisms, and PTG. Further studies with a prospective design could further clarify the needs of the MG requiring psychotherapeutic interventions.     

The utility of the Kessler Screening Scale for Psychological Distress (K6) in two American Indian communities

The Kessler Screening Scale for Psychological Distress (K6; Kessler et al., 2002) has been used widely as a screener for mental health problems and as a measure of severity of impact of mental health problems. However, the applicability and utility of this measure for assessments within American Indian communities has not been explored. Data were drawn from a large-scale epidemiological study conducted in cooperation with 2 American Indian populations. Participants (N = 3,084) were 15-54 years of age and living on or near their home reservations; each completed an interview that included a version of the Composite International Diagnostic Interview (Robins, Wing, Wittchen, & Helzer, 1988) and the K6. A measure of both physical- and mental-health-related quality of life-the Medical Outcome Study's Short Form-36 (Ware & Sherbourne, 1992)-was used to examine the importance of the K6 over and above psychiatric diagnoses. The K6 was shown to be an appropriate screening and severity measure for mood disorders in these 2 samples. It also predicted health-related quality of life over and above that predicted by diagnoses alone. Inclusion of a measure such as the K6 as a complement to more traditional dichotomous diagnoses in both research and clinical practice is recommended.     

Personality Dysfunction, Coping Styles, and Clinical Symptoms in Younger and Older Adults

This study examined age-related differences in personality disorders, dispositional coping strategies, and clinical symptoms between younger (n = 79; age range = 18–29; M age = 21.2 years) and older (n = 79; age range = 55–89; M age = 65.5 years) persons (matched on gender and ethnicity). Participants completed the Coolidge Axis II Inventory (CATI), Coping Orientations to Problems Experienced Scale (COPE), and Brief Symptom Inventory (BSI). Personality results (t tests) based on the CATI revealed that older persons were significantly more obsessive–compulsive and schizoid than younger adults but significantly lower on 7 scales, including antisocial, borderline, histrionic, and sadistic. As assessed by the COPE, older adults reported lower levels of dysfunctional coping strategies than younger adults. Specifically, older persons were less likely to use mental disengagement, venting of emotions, and alcohol/drugs to cope with problems. BSI results for clinical symptoms revealed that younger adults were significantly higher on 5 of 9 scales, including anxiety, depression, and hostility. Results suggest that younger adults experience higher levels of personality and clinical symptoms and use more dysfunctional coping strategies than older adults, dispelling the myth that old age is associated with inevitable psychological impairment. Theoretical considerations, clinical implications, and future research ideas are discussed.     

The Effects of Perceived Dysfunctional Family-of-Origin Rules on the Dating Relationships of Young Adults

This study examined the effects of perceived dysfunctional family-of-origin rules on the dating relationships of young adult offspring. A sample of 322 students from three universities completed self-report questionnaires measuring dysfunctional family-of-origin rules, current dating behaviors, dating anxiety, relationship satisfaction and commitment. The results indicated that dysfunctional family-of-origin rules were positively related to dating anxiety, and negatively related to advancement in dating stages, relationship satisfaction, and commitment in the dating relationships of young adults. There also was a tendency for young adults from families with dysfunctional rules to date later and less frequently than young adults from families with more functional rules, although they dated about the same number of partners. Implications for future research and clinical interventions are discussed.     

A multiple group psychotherapy approach to adolescents with psychiatric and substance abuse comorbidity.

Multiple group psychotherapy was employed as the primary treatment modality in a day-treatment program as an innovative multifaceted approach to treating adolescents comorbid for psychiatric and substance abuse diagnoses. The concurrent educational program included a high school on site. The groups included Substance Abuse Group, which promoted the 12-step model; Health Group; Psychotherapy Group; Leisure Time Group; Self-Awareness Group; and Multiple Family Group. The effect of the multiple groups was to provide a variety of experiences focusing on varied aspects of normal and dysfunctional adolescent development. Together the combination of groups served to strengthen the participants' cohesiveness, communicating skills, and hopefulness.     

The Relationship Between Childhood Onset Obesity and Psychopathology in Adulthood

We administered the Symptom Checklist (Derogatis, 1975; SCL-90-R) to 37 obese subjects in outpatient treatment for obesity. Patients with early onset obesity demonstrated a greater frequency and higher levels of emotional distress and psychiatric symptomatology than patients with late onset obesity. Individuals who developed obesity in childhood showed more psychopathology than those who developed obesity later in life. Overall, these findings support the belief that obesity is characteristically associated with greater internal psychological conflict. These findings further suggest that childhood obesity could serve as a predictor variable for possible future psychological disturbance in obese populations.     

Adult Children of Alcoholics In and Out of Psychotherapy: Issues of Intimacy and Interpersonal Relationships1

We examined differences between treatment-seeking and nontreatment-seeking adult children of alcoholics (ACOAs) and adult children of nonalcoholics (ACONAs) in regard to numerous aspects of interpersonal and intimate relationships. The subjects were 278 college students, aged 18 to 34. Consistent with many other studies, there were numerous differences between ACOAs in treatment and ACONAs not in treatment, although further analyses confirmed the methodological flaw and confound in such comparisons. There were no significant interactions between ACOA and treatment status, nor between ACOAs and ACONAs, regardless of treatment status, with only one likely chance exception of self-regard (ACONAs not in treatment reported higher self-regard than did ACOAs not in treatment). Finally, those seeking treatment reported significantly less affectional expression, lower self-regard, more depressive traits, and less dating competence and assertiveness compared to those not in treatment regardless of ACOA status. Therefore, treatment-seeking status and not ACOA status account for intimacy and interpersonal problems in this study and probably many others.